Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | DC0139940 | CA |
N | 111NX0100X | Occupational Health | DC0139940 | CA |
NPI | 1477559003 |
---|---|
Provider Name | Dr. David Robert Dame |
First Address | Roseville, CA 95661-2934 |
Second Address | Roseville, CA 95661-2934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2005 |
Last Update Date | 08/07/2007 |